持续正压通气和N-乙酰半胱氨酸治疗对中重度OSAHS患者血清氧化应激及炎症水平的影响

Influence of continuous positive airway pressure ventilation and N-acetylcysteine treatment on the levels of serum oxidative stress and inflammatory markers in the patients with moderate-severe OSAHS

目的:探讨持续正压通气(CPAP)和N-乙酰半胱氨酸(NAC)治疗对中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清中氧化应激及炎症因子的影响。方法:对116例中重度OSAHS患者(中重度OSAHS组)和40名健康者(正常对照组)血清中氧化应激(8-羟基脱氧鸟嘌呤,8-异前列腺素,丙二醛)及炎症指标(肿瘤坏死因子-ɑ;白细胞介素-6;超敏C-反应蛋白)的水平进行检测;对其中50例中重度OSAHS患者进行持续正压通气治疗(CPAP组),66例中重度OSAHS患者口服NAC治疗(NAC组),3个月后复测上述氧化应激和炎症指标的水平。结果:①与正常对照组相比,中重度OSAHS组患者血清中上述氧化应激及炎症指标的水平明显增高,差异具有统计学意义(P<0. 01);②CPAP和NAC组在治疗后血清中氧化应激及炎症指标的水平均显著下降(P<0. 05),但前者降低更加明显(P<0. 05)。结论:中重度OSAHS患者血清中氧化应激和炎症因子水平升高,CPAP和NAC治疗可对氧化应激及炎症状态有效干预,对机体可能具有保护作用。

Objective:To explore the influence of continuous positive airway pressure(CPAP)ventilation and N-acetylcysteine(NAC)treatment on the levels of serum oxidative stress and inflammatory markers in the patients with moderate-severe obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:We selected 116 patients with moderate-severe OSAHS as the moderate-severe OSAHS group and 40 healthy adults as the control group.In the moderate-severe group,50 patients were treated with CPAP ventilation(the CPAP group)and another 66 patients were prescribed by NAC(the NAC group)for 3 months.Then,the levels of serum oxidative stress factors including 8-hydroxy-2′-deoxyguanosine(8-OHdG),8-iso-prostaglandin(8-IsoPG),malondialdehyde(MDA)and inflamma-tion markers including tumor necrosis factor-ɑ(TNF-ɑ),interleukin-6(IL-6),high sensitive C-reactive protein(hs-CRP)were detected.Results:The levels of serum oxidative stress and inflammation mark-ers in the moderate-severe OSAHS group were significantly higher than those of the control group(P<0.01).The levels of serum oxidative stress and inflammatory markers in the CPAP and NAC groups decreased significantly after treatment(P<0.05),but the decreased level in the CPAP group were more significantly than that in the NAC group(P<0.05).Conclusion:The levels of serum oxi-dative stress and inflammatory markers in the patients with moderate-severe OSAHS are higher,the therapy by using CPAP and NAC can effectively interfere with oxidative stress and inflammatory state,and may have protective effects on the body.